No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium*

Succinylcholine (Sch) has long been used to facilitate laryngoscopy and endotracheal intubation for general anesthesia, because of a rapid onset of intense but brief paralysis. However, exaggerated potassium (K+) release following Sch, sufficient to cause ventricular dysrhythmias and cardiac arrest, has sporadically been reported in susceptible conditions, including spinal cord injury, severe burn, massive trauma and neuromuscular disorder. And diazepam has been shown to attenuate the increase in serum K+ following Sch administration. The purpose of this study was to assess the effect of Sch on serum K+ in patients with spinal cord lesions, and to assess the effect of pretreatment with diazepam (0.05 mg/kg IV) on potassium flux. The results were as follows: 1) Baseline K+ values were not significantly different among the groups. 2) The time to peak increases in K+ was 3 minutes following Sch in all groups. 3) The magnitude of maximum increases in K' following Sch were 0.32 Eq/l, 0.63 mEq/l, 0.06 mEq/I and 1,10 mEq/I in group 1, group 2A, group 2B, and group 3, respectively. 4) Diazepam pretreatment attenuated the increases in K+ following Sch. From the above results, it can be concluded that Sch may safely be used to facilitate intubation in paraplegic patients, provided that they are normokalemic and pretreated with diazepam.
Anesthesia, General ; Burns ; Diazepam ; Heart Arrest ; Humans ; Hypnotics and Sedatives ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Paralysis ; Potassium* ; Spinal Cord Injuries ; Spinal Cord* ; Succinylcholine*

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals

BACKGROUND: Stunned myocardium may be mediated by intracellular Ca2+ overloading or oxygen derived-free radicals. Halothane and propofol have been shown to block Ca2+ channels. Propofol is also known to have antioxidant properties. The present study was aimed to investigate the effects of anesthetics on recovery of postischemic, reperfused myocardium in open-chest dogs. Incidence of ventricular arrhythmia upon ischemia and reperfusion was also determined. METHODS: Forty dogs were subjected to 15 min occlusion of left anterior descending coronary artery (LAD) followed by 3 hr reperfusion during halothane (n=10), fentanyl (n=12), or propofol plus fentanyl (n=11) anesthesia. Regional contractile function was assessed using percent systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and peak systolic intramyocardial pressure (IMPs). Diastolic function was evaluated using time constant for isovolumic intramyocardial pressure decline of left ventricle (IMP-tau) and percent post-systolic shortening (%PSS). RESULTS: %SS in the halothane, fentanyl, and propofol-fentanyl groups was similar at 3 hours of reperfusion (58%, 60%, and 55% of baseline value, respectively). Moreover, Mw recovered to the baseline values in the early reperfusion period in all three groups. However, IMP-tau was significantly prolonged in the halothane group throughout the 3 hour reperfusion period, whereas it remained unchanged in the fentanyl and propofol-fentanyl groups. Coronary occlusion was associated with 9, 33, and 0% mortality rate due to ventricular fibrillation upon ischemia and reperfusion in the halothane, fentanyl, and propofol-fentanyl groups, respectively. CONCLUSION: These findings indicate that halothane, but not fentanyl and propofol- fentanyl, impairs myocardial relaxation, while recovery pattern of contractile function do not differ among three groups, and that halothane and propofol reduce reperfusion arrhythmia in the canine model of myocardial stunning.
Anesthesia* ; Anesthetics ; Animals ; Arrhythmias, Cardiac ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Fentanyl* ; Halothane* ; Heart Ventricles ; Incidence ; Ischemia ; Mortality ; Myocardial Stunning* ; Myocardium ; Oxygen ; Propofol ; Relaxation ; Reperfusion ; Stroke ; Ventricular Fibrillation

C-fos protein is a gene regulatory third messenger involved in long-term responses of cells to various stimuli. Kainic acid(KA), a powerful excitatory analogue, induces seizures and damages the hippocampus and other limbic regions in rats. KA treatment induces c-fos protein production in the hippocampus. This study was undertaken to investigate the expression of c-fos protein in the hippocampus according to seizure stage induced by systemic injection of KA. Twenty-three adult male Sprague-Dawley rats experienced convulsions by a single intraperitoneal injection of convulsive dose (20-40 mg/Kg) of KA. Seven control rats received normal saline. Animals were sacrificed 3 hr after KA treatment. The expression of c-fos protein was tested in the hippocampus by immunohistochemical staining using polyclonal anti-Fos. Most of the rats exhibited limbic motor epileptic activity. C-fos protein immunoreactivity increased in the CA1, CA3 and dentate gyrus at stage 1-2, and not only in the CA1, CA3 and dentate gyrus but also in the CA4 at stage 3-4. At stage 5, c-fos protein immunoreactivity increased in all areas of the hippocampus. C-fos protein immunoreactivity increased progressively with increasing severity of convulsions. These results show that KA produces limbic motor seizure associated with a rise in the c-fos protein in the hippocampus, and that the expression of c-fos protein may has some relevance to the progressive and permanent brain changes occurring during epilepsy.
Adult ; Animals ; Brain ; Dentate Gyrus ; Epilepsy ; Genes, vif ; Hippocampus* ; Humans ; Injections, Intraperitoneal ; Male ; Rats* ; Rats, Sprague-Dawley ; Seizures*

PURPOSE: To describe MR imaging features of hypoxic brain damage in relation to time elapse and prog-nosis of patients. MATERIALS AND METHODS: We reviewed 19 MR studies of 18 patients with hypoxic brain damage. MR imaging studies were performed between 1 to 20 days after the hypoxic insults (mean 8.6 days). MR images were analyzed with regard to the locations of abnormal signal intensities, the presence of brain edema. And imaging findings were correlated with the time elapse after the insults and the prognosis of patients. RESULTS: On 19 cases of MR studies, abnormal high intensities on T2-weighted images were found in the basal ganglia (15, 78.9%), cerebral cortex (13, 68.4%), white matter (9, 47.4%), thalamus (6, 31.6%), cerebellum (4, 21.1%) and brainstem (1, 5.3%), respectively. Cerebral cortical involvement was typically bilateral and diffuse, but sometimes limited to the parieto-occipital area. The brainstem and cerebellar involvement was rare and in all cases, cerebral cortical lesions accompanied. Most of the white matter lesions were accompanied with cortical and deep gray matter lesions and found in subacute period(>6 days). The cortical high signal intensity lesions on T1-weighted image were found mostly in subacute stage, but in some cases involvement was also found in acute stage (< or =6 days). The cortical edema is found on 11 cases in acute and subacute stages. In cases of recovered consciousness, cortical involvement and edema on MR were rare. CONCLUSION: MR findings of hypoxic brain damage were various, but diffuse bilateral involvement of cortex and/or deep gray matter was found in most of the cases. White matter involvement was rarely found in acute stage and usually found in subacute stage. In cases of good pronosis, cortical involvement and edema were rare.
Anoxia ; Basal Ganglia ; Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Consciousness ; Edema ; Humans ; Hypoxia, Brain* ; Magnetic Resonance Imaging ; Prognosis* ; Thalamus

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

Laryngoscopy and endotracheal intubation in patients undergoing general anesthesia causes hypertension and tachycardia with concomitant increases in plasma catecholamine concentration. These transient stress responses are greatly exaggerated in patients with hypertension and cardiovascular disease and can lead to cardiac arrhythmia, pulmonary edema, cardiac failure and cerebral hemorrhage. Therefore, several attempts have been made to attenuate the hypertensive and tachycardiac responses, but none have been satisfactory. This study was designed to evaluate verapamil or propranolol as a valuable adjuvant in attenuating hemodynamic responses to tracheal intubation in 53 patients with hypertension. They were randomly divided into three groups according to premedication used. Group 1 (n=19) was without pretreatment, and group 2 (n=18) and group 3 (n=16) were pretreated with verapamil (0.1 mg/kg) iv and verapamil (0. 1 mg/kg)-propranolol (0.01 mg/kg) mixture iv, respectively, just prior to the intubation. Mean arterial pressure (MAP) and heart rate (HR) were measured, just prior to intubation (baseline), after induction, and at 1, 2, 3, 4, 5 and 7 minutes following intubation. The results were as follows. 1) In the control group. tracheal intubation produced increases in MAP (27% average increase from baseline) and heart rate (31% increase) at one minute after the procedure. 2) In group 2, verapamil abolished pressor response to tracheal intubation, but did not affect tachycardiac responses. 3) In group 3, the verapamil-propranolol mixture attenuated both pressor and tachycardiac responses to tracheal intubation. 4) The rate-pressure product increased after tracheal intubation by 61% and 31% in group 1 and group 2, respectively, but it remained unchanged in group 3. These findings suggest that intravenous verapamil-propranolol mixture is a valuable adjuvant in attenuating hypertensive and tachyeardiac responses to tracheal intubation.
Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; Cardiovascular Diseases ; Cerebral Hemorrhage ; Heart Failure ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy* ; Plasma ; Premedication ; Propranolol* ; Pulmonary Edema ; Tachycardia ; Verapamil*

OBJECTIVE: To investigate the prevalence, risk factors of overactive bladder (OAB) and the factors affecting the severity of OAB symptoms. METHODS: A total 822 interviews with women aged 18–80 years who visited public health centers were conducted between April 2014 and April 2015. The questionnaire was composed of 16 questions about urinary symptoms, 14 questions about self-treatment and the use of complementary and alternative medicine, and 21 questions about socio-demographic characteristics. The diagnostic criterion for OAB is a total OAB symptom score of 3 and more, with an urgency score of 2 or more. To know the risk factors and factors affecting the severity of OAB, the multivariate logistic regression analysis was performed. RESULTS: One hundred fifty-seven participants (19.3%) were diagnosed with OAB, of whom 10.7%, 8.1%, and 0.7% had mild, moderate, and severe OAB symptoms, respectively. In addition, the prevalence of OAB increased with age. Among all the participants, 39.1% had stress incontinence, among them 32.7% had OAB as well. The significant risk factors of OAB were identified as age, current smoking, hyperlipidemia, cardiovascular and renal disease, whereas, the factors affecting the severity of OAB were age, current smoking, and hyperlipidemia. CONCLUSION: Those who have risk factors and factors affecting severity of OAB should be educated to increase OAB awareness and act of urinary health promotion.
Complementary Therapies ; Epidemiology ; Female ; Health Promotion ; Humans ; Hyperlipidemias ; Logistic Models ; Prevalence ; Public Health* ; Risk Factors* ; Smoke ; Smoking ; Urinary Bladder, Overactive*

BACKGROUND: A peripheral blood smear has been the gold standard method for the diagnosis of malaria infection. Recently, many other methods have been introduced, although having inferior sensitivity and specificity to peripheral blood smears. We evaluated Neodin malaria PCR kit and its applicability in clinical settings. METHODS: Samples from seventy patients who visited Korea University hospital were used for evaluation. DNA from EDTA blood was tested in nested multiplex PCR and 470 bp for Plasmodium vivax or 340 bp for Plasmodium falciparum was confirmed after electrophoresis. The detection limit was determined by dilution of malaria positive blood with normal blood. RESULTS: Thirty-five cases of P. vivax and 10 cases of P. falciparum were noted. Except for a case of falciparum malaria, all positive cases were consistent with the peripheral blood smear results. Detection limit was 3.6 parasite/microL. CONCLUSIONS: Neodin malaria nested multiplex PCR has high sensitivity and the ability for species discrimination and may be available in the diagnosis of malaria infection.
Diagnosis* ; Discrimination (Psychology) ; DNA ; Edetic Acid ; Electrophoresis ; Humans ; Korea ; Limit of Detection ; Malaria* ; Multiplex Polymerase Chain Reaction* ; Plasmodium falciparum ; Plasmodium vivax ; Polymerase Chain Reaction ; Sensitivity and Specificity